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Psilocybin (Magic Mushrooms)

Psilocybin is the active substance in magic mushrooms; human studies show effects in depression, addiction, compulsion and anxiety, with partly mixed findings.

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We evaluated 323 human studies on Psilocybin (magic mushrooms), including 90 randomised controlled trials and 88 meta-analyses or systematic reviews; the controlled studies include 5,670 participants in total. As of 3 October 2026.

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1. What Is Psilocybin (Magic Mushrooms)? Occurrence, Origin and Forms

Psilocybin is the active compound of so-called magic mushrooms, above all fungi of the genus Psilocybe. In the body it is converted to psilocin, which binds to serotonin receptors in the brain, mainly the 5-HT2A receptor, and strongly alters perception, mood and thinking for several hours.

Psilocybin occurs in more than a hundred mushroom species worldwide, with strongly varying content.

Clinical studies mostly give synthetic psilocybin in precisely dosed capsules, often once or twice and with therapeutic support. There are also studies on very small doses (microdosing) and on dried mushrooms.

Forms and Preparations Studied

  • Synthetic psilocybin capsules
  • Psilocybin-assisted psychotherapy
  • Microdosing with very small doses
  • Dried mushrooms and mushroom preparations

Not covered on this page:

2. What Does Psilocybin (Magic Mushrooms) Do? Results by Area

AreaResult in controlled studiesStrength of evidenceStudiesParticipants
Depressionmostly improvedhigh40 meta-analyses · 36 controlled · 78 other1,707
Anxiety and distress in serious illnessmixedhigh16 meta-analyses · 11 controlled · 41 other384
Addiction: alcohol and smokingmostly improvedhigh8 meta-analyses · 10 controlled · 30 other475
Obsessive-compulsive and eating disordersmostly improvedhigh5 meta-analyses · 5 controlled · 9 other83
Memory, dementia and Alzheimer's diseasemostly no differencemoderate7 meta-analyses · 12 controlled · 8 other417
Headache and migrainemostly no differencelow1 meta-analyses · 3 controlled · 12 other44
Other outcomesmixedhigh29 meta-analyses · 82 controlled · 82 other3,766

How to read the table: counted are human studies whose results concern the area. “High” means at least one meta-analysis and two controlled studies showing improvement, or at least three controlled studies of which three quarters show improvement, with at least 300 participants in total. “Moderate” means at least two controlled studies showing improvement, as a majority, or one meta-analysis alongside controlled studies. “Low” means one controlled study showing improvement. Where an area has no controlled study, the strength of evidence is at most “low” (result “reviews only” or “observational data only”). Everything else is “unclear”. A study counts as showing improvement when at least half of its outcomes in this area improved. Reviews of combination products do not count as meta-analyses; results that only describe side effects or shares of users do not count as an effect. The same study is counted only once.

3. What the Studies Show in Detail

Psilocybin (Magic Mushrooms) and Depression: Human Studies

In depression, psilocybin showed an improvement in symptoms on the MADRS scale in several controlled studies 9297108117. On the HAM-D scale, the values in a randomized study were significantly lower than those of the waiting group 136; in follow-up observations, the improvement lasted up to twelve months 94135. Response and remission were more frequent than under control in meta-analyses of randomized studies 81834. Investigated were primarily synthetic psilocybin as a capsule, usually with psychological support, as well as psilocybin-assisted psychotherapy; dose and number of sessions are in the study cards. However, several controlled studies found no advantage: after one year, the MADRS value no longer differed from the control 124, and for response, a larger study found no difference 93. Compared with escitalopram, the QIDS value after six months was the same 110, and microdosing was not superior to placebo 120. What remains open are the long-term effect beyond the investigated periods, the significance of therapeutic support and the transferability to non-treatment-resistant courses.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
1 Guo et al. 2024meta-analysis · 12,105 participantsPsilocybin versus seven other augmentation therapies; vs. placebo and other augmentation strategiesresponse and remission rates: improved
7 Singleton et al. 2025meta-analysis · 711 participantsPsilocybin or psilocybin-assisted therapy; Primary study endpoint; effects over several weeks; vs. Placebo or waitlist controlStandardized mean difference in depression scores (Hedges' g): improved (Hedges' g = –0.91 (95% CI, [-1.35; –0.48]; k = 9; p = 0.0013, I2 = 58.1%, tau2 = 0.13, n = 501)); Time course of effect (meta-regression): no difference (intercept = –0.92 [-1.26; –0.58], p < 0.0001; slope = 0.0009 [-0.0023; 0.0041], p = 0.57)
8 Haikazian et al. 2023meta-analysis · 686 participantsPsilocybin-assisted psychotherapy; vs. Control arm (randomized trials) or baseline (open-label trials)Depression severity (SMD): improved (SMD = -0.78; p<0.001); Response rate: improved; Remission rate: improved
9 Borgogna et al. 2025meta-analysis · 602 participantsPsilocybin (form not further specified in abstract); vs. Control groups of included RCTs; manufacturer-fundedDepression reduction (Hedges' g): improved (g = 0.62; 95% CI = 0.27, 0.98); Heterogeneity of effects: unclear (τ = .47); Smaller studies with stronger effects (Egger's b0): unclear (Egger's b0 = 3.63, p = .014)
12 Fang et al. 2024meta-analysis · 524 participantsPsilocybin; therapeutic effects increase with increasing doses; vs. control group in randomized trialseffect size Hedges' g: improved (Hedge's g =-0.89, 95% CI -1.25~-0.53, I² = 70.19%, P<0.01); response rate: unclear
13 Syed et al. 2026meta-analysis · 522 participantsPsilocybin-assisted therapy (PAT); partly bodyweight-adjusted, partly fixed; preparation, dosing and integration sessions; vs. different PAT methodologies in subgroup analysisStandardized mean difference of depressive symptoms pre- vs. post-treatment: improved (large and significant antidepressant effect); Subgroup differences by methodology (bodyweight-adjusted dose, longer sessions, non-manualized psychotherapy): improved (non-significant differences in subgroup heterogeneity)
14 Perez et al. 2023systematic review · 489 participantsPsilocybin, fixed dose, double-blind placebo-controlled; ED95 8.92 / 24.68 / 36.08 mg/70 kg per group; vs. Placebo95% effective dose per day (ED95) for secondary depression: improved (8.92); 95% effective dose per day (ED95) for primary depression: improved (24.68); 95% effective dose per day (ED95) for both subgroups: improved (36.08)
16 Li et al. 2024systematic review · 472 participantsPsilocybin (form not specified); vs. Control group (n = 198)Improvement in depressive symptoms: improved (three (60%) found that psilocybin had a beneficial effect on MDD treatment)

Further studies in this area: 17 18 19 20 21 22 25 26 27 28 29 30 31 33 34 35 36 37 39 40 42 44 45 49 50 53 54 55 59 60 61 63 64 65 67 69 70 71 72 73 74 75 76 78 79 82 83 85 88 92 93 94 97 108 109 110 111 112 113 114 116 117 118 119 120 124 125 127 128 129 130 131 135 136 138 139 142 151 170 173 174 197 198 200 208 219 224 228 229 230 236 237 238 239 243 244 245 249 251 256 257 259 261 262 263 264 265 266 267 268 269 270 271 274 275 276 277 278 279 281 282 283 284 286 288 289 291 294 296 297 299 300 302 303 304 305 307 308 309 310 311 312 313 315 316 317

Psilocybin (Magic Mushrooms), Anxiety and Distress in Serious Illness: Human Studies

In end-of-life anxiety, psilocybin-assisted therapy alleviated the symptoms more than placebo in a meta-analysis 81, as well as in two pooled placebo-controlled studies in cancer patients 26. A randomized double-blind study in life-threatening cancer disease found a significant decrease in anxiety under high dose, which persisted after six months 119. Anxiety together with depression improved under psilocybin-assisted therapy in life-threatening illness 2269. In contrast, there are controlled studies that found no difference from placebo in anxiety, for example in depression without serious illness 197 and in microdosing 208. A meta-analysis in cancer patients found mixed results for anxiety 29. Individual controlled studies reported a temporary worsening of anxiety 11103. The findings apply to synthetic psilocybin as a capsule and to psilocybin-assisted psychotherapy; dose, number of sessions and support differ between the studies and shape the results. For microdosing with very small doses, the data situation on anxiety is inconsistent 31. Regarding mixtures with MDMA, LSD, ayahuasca or ketamine, no statements specifically about psilocybin can be derived 7083.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
11 Yerubandi et al. 2024meta-analysis · 528 participantsPsilocybin at therapeutic doses (high or moderate); therapeutic single dose (high or moderate); acute effects, resolved within 48 hours; vs. placebo, low-dose psilocybin, or other comparatorAnxiety: worsened (RR, 2.27; 95% CI, 1.11-4.64)
16 Li et al. 2024systematic review · 472 participantsPsilocybin (form not specified); vs. Control group (n = 198)Improvement in anxiety symptoms: improved (significantly more effective than the control group)
22 Shore et al. 2019systematic review · 169 participantsPsilocybin in psilocybin-assisted therapy; medium to high doses; vs. only 5 randomized controlled trialsefficacy in anxiety or depression in life-threatening cancer: improved
24 Bader et al. 2024meta-analysis · 132 participantsPsilocybin (not further specified); Follow-up 4 to 6.5 months; vs. Post-administration versus baselineAnxiety symptoms at 4 to 4.5 months: improved (35.15 (95%CI: 32.28-38.01)); Anxiety symptoms at 6 to 6.5 months: improved (33.06 (95%CI: 28.73-37.40))
26 Petridis et al. 2024meta-analysis · 79 participantsPsilocybin-assisted psychotherapy (PAP); vs. Placebo-controlled crossover trialsAnxiety: improved
27 Matos et al. 2026systematic review · 74 participantsPsilocybin-assisted therapy; Follow-up up to 6-8 months, in one study up to 4.5 years; vs. Randomized and open-label trials, controls not further reportedClinically significant anxiety reduction (HAM-A, STAI): improved (57-79% of participants achieving ⩾ 50% symptom reduction)
29 Moshfeghinia et al. 2026meta-analysisPsilocybin, often with psychotherapy as co-intervention; Short-term 2-5 weeks, long-term 6 months; vs. Randomized and non-randomized controlled trialsAnxiety (HADS-A): no difference (SMD = - 3.63, p = 0.11); Anxiety (STAI): unclear (inconsistent results); Short-term anxiety (HADS-A): improved (SMD = - 1.99)
31 Meshkat et al. 2026systematic reviewLow-dose psilocybin, sometimes with psychotherapy, sometimes with escitalopram; 1-3 mg per 70 kg single dose or 0.1-0.2 g dried mushrooms every 3 days; up to 3 years; assessments at week 3 and 12; vs. placebo, higher dose (10/25 mg) or 25 mg plus escitalopramAnxiety remission in one trial: improved (12%); Transient anxiety improvement with 1 mg: improved

Further studies in this area: 36 42 44 53 57 61 65 69 70 71 76 79 81 83 85 88 103 112 115 119 124 125 140 149 176 197 208 213 219 229 230 241 244 246 255 258 265 268 271 274 276 277 280 281 282 283 286 289 291 296 297 299 300 302 305 310 313 315 316 317

Psilocybin (Magic Mushrooms), Addiction: Alcohol and Smoking: Human Studies

In alcohol dependence with depressive symptoms, a small randomized study under psilocybin found more abstinence and fewer drinking days than under a very low comparison dose 128. The same study also found less craving for alcohol 128. In smoking cessation, after six months, more participants in a randomized pilot study were smoke-free than with nicotine patches 105. The studies are small, mostly tested psilocybin together with structured psychotherapy, and the control conditions differed greatly. For microdosing with very small doses, the data situation is inconsistent and based predominantly on self-reports 3. Investigated forms were synthetic psilocybin as a capsule, psilocybin-assisted psychotherapy as well as dried mushrooms and truffles; what remains open are long-term effects, optimal dose and the question of how much psychotherapy contributes to the result.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
3 Page et al. 2026systematic review · 3,262 participantspsilocybin magic mushrooms and truffles; extremely heterogeneous dosing protocols, no uniform dose; vs. no uniform comparator; mostly self-reported, qualitative studiessubstance dependence: unclear
4 Piper et al. 2025systematic review · 2,035 participantsPsilocybin-assisted treatment (comparators: LSD, mescaline, ayahuasca, ketamine, ibogaine, MDMA); vs. Placebo-controlled RCTs and open-label studiesEfficacy for alcohol use disorder: improved; Efficacy for tobacco use disorder: improved
22 Shore et al. 2019systematic review · 169 participantsPsilocybin in psilocybin-assisted therapy; medium to high doses; vs. only 5 randomized controlled trialsefficacy in substance use disorder: improved
23 van et al. 2023systematic review · 151 participantsPsilocybin combined with psychotherapy; 6 to 40 mg; Follow-up up to 6 years; vs. Placebo (in one RCT) or baselinePercentage of heavy drinking days: improved (mean difference of 26.0, 95% CI = 8.7-43.2, p = 0.008); Complete alcohol abstinence: improved (32% (10/31)); Percentage of heavy drinking days: improved (mean difference of 13.9, 95% CI = 3.0-24.7, p = 0.01)
32 Strika-Bruneau et al. 2026systematic reviewPsilocybin within structured psychotherapeutic protocols; repeated high-dose sessions (no numbers given); studies 2000–2026; follow-up not reported; vs. no uniform active comparator; heterogeneous designssubstance use: improved; abstinence rates: improved
41 Hogea et al. 2025systematic reviewPsilocybin and other psychedelics, partly with psychotherapy; Dosages varied widely across studies; Studies from 2013 to 2023; vs. various clinical trials and RCTs, no uniform controlCravings and long-term abstinence in alcohol and tobacco dependence: improved; Substance use reduction, especially with psychotherapy: improved
48 Meshkat et al. 2025systematic reviewPsilocybin with assisted psychotherapy (PAP); from microdosing to 20-40 mg/70 kg; vs. open-label trials, observational studies, one double-blind RCTalcohol consumption: improved (significant reductions in alcohol consumption); heavy drinking days: improved (fewer heavy drinking days); abstinence rates: improved (increased abstinence rates)
53 Dominiak et al. 2025systematic reviewPsilocybin-assisted therapy (also MDMA, LSD, ayahuasca); Benefits reported up to six months; vs. Control groups of included randomized trialsAlcohol use disorder (LSD): improved (OR ≈ 2.0)

Further studies in this area: 65 76 82 83 88 98 102 104 105 122 128 148 149 160 163 213 226 235 244 247 250 254 265 271 272 274 276 281 285 286 288 296 299 305 310 312 313 316 317 318

Psilocybin (Magic Mushrooms), Obsessive-Compulsive and Eating Disorders: Human Studies

In obsessive-compulsive disorder, several controlled studies with synthetic psilocybin as a capsule showed a decrease in obsessive-compulsive symptoms on the Y-BOCS scale 132151156. More participants responded than under niacin 132; after eight weeks of repeated doses, several participants achieved remission 156. In one controlled study, the obsession subscale narrowly missed significance; in another, the Y-BOCS values did not differ between the doses 151203. The studies are small, usually last only weeks, and some compare only different dose levels instead of placebo 151203. For eating disorders, a systematic review found indications of tolerability in anorexia nervosa, but the therapeutic potential remained unclear 52. Synthetic psilocybin as a capsule was usually given with psychological support in the controlled studies; dose and support differ between the studies.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
22 Shore et al. 2019systematic review · 169 participantsPsilocybin in psilocybin-assisted therapy; medium to high doses; vs. only 5 randomized controlled trialsefficacy in obsessive-compulsive disorder: improved
26 Petridis et al. 2024meta-analysis · 79 participantsPsilocybin-assisted psychotherapy (PAP); vs. Placebo-controlled crossover trialsObsession-compulsion: improved
52 Bevione et al. 2025systematic reviewPsilocybin; vs. no control group in included studiesSafety and tolerability in anorexia nervosa; Therapeutic potential in eating disorders: unclear
65 Madden et al. 2024systematic reviewPsilocybinFrequency of obsessive-compulsive disorder: unclear (3%)
82 Castro et al. 2021systematic reviewPsilocybin; vs. Control groups in randomized trials or baseline in open-label studiesPsychiatric rating scale scores: improved
83 Berkovitch et al. 2021systematic reviewPsilocybin, ayahuasca, LSD (psychedelics); Single dose, effects lasting several months; vs. Placebo, open-label studies, long-term follow-upEfficacy in obsessive-compulsive disorder: improved
132 Kelmendi et al. 2026randomised controlled · 28 participantsSingle dose of psilocybin versus niacin (control); 0.25 mg/kg psilocybin; niacin 250 mg; Single dose, follow-up through 12 weeks; vs. Niacin 250 mg, double-blind, randomizedAcute Yale-Brown Obsessive-Compulsive Scale (A-YBOCS) at 48 hours: improved (between-group difference, 9.83 points; 95% CI, 5.19-14.91; P<0.001; Cohen's d=1.64); Response (≥35% Y-BOCS reduction) at one week: improved (69.2% (9/13) versus 0% (0/14) (P<0.001; number needed to treat, 1.4)); A-YBOCS in open-label treatment at 48 hours: improved (decreased by 6.14 points (95% CI, 2.56-9.72; P=0.003))
151 Pellegrini et al. 2025randomised controlled · 19 participantsOral psilocybin doses, 1 mg then 10 mg, fixed order; 1 mg, then 10 mg, 4 weeks apart; Assessments up to 4 weeks after each dose; vs. 1 mg versus 10 mg psilocybin (no placebo control)Y-BOCS total score one week after dosing: improved (Cohen's d = 0.82, p = 0.002); Y-BOCS compulsion subscale one week after dosing: improved (Cohen's d: 0.74, p = 0.003); Y-BOCS obsession subscale one week after dosing: no difference (Cohen's d: 0.50, p = 0.06)

Further studies in this area: 156 159 203 231 248 252 276 286 290 310 314

Psilocybin (Magic Mushrooms), Memory, Dementia and Alzheimer's Disease: Human Studies

Studies in people with dementia or Alzheimer's are lacking. Controlled studies in healthy individuals found altered connections between brain networks after psilocybin, sometimes stronger, sometimes weaker 143145161. Whether this results in a benefit for memory or in dementia has not been investigated. At low doses, attention and impulse control remained unchanged in a placebo-controlled study 115; a review in healthy individuals, by contrast, describes acute impairments in attention and inhibition 66. Investigated forms were synthetic psilocybin as a capsule, microdosing with very small doses and psilocybin-assisted psychotherapy; it remains open whether these findings are transferable to people with dementia or Alzheimer's.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
31 Meshkat et al. 2026systematic reviewLow-dose psilocybin, sometimes with psychotherapy, sometimes with escitalopram; 1-3 mg per 70 kg single dose or 0.1-0.2 g dried mushrooms every 3 days; up to 3 years; assessments at week 3 and 12; vs. placebo, higher dose (10/25 mg) or 25 mg plus escitalopramTransient cognitive function improvement with 1 mg: improved
37 Sabbah et al. 2026systematic reviewPsilocybin (in the included neuroimaging studies); Early 0-4 weeks, longer-term 5+ weeks post-treatment; vs. No uniform comparator; correlation of imaging findings with clinical scalesReduced network modularity and increased global brain integration (0-4 weeks): unclear; Sustained reorganization of large-scale networks, increased prefrontal-parietal and salience connectivity (5+ weeks): unclear
48 Meshkat et al. 2025systematic reviewPsilocybin with assisted psychotherapy (PAP); from microdosing to 20-40 mg/70 kg; vs. open-label trials, observational studies, one double-blind RCTbrain activity (neuroimaging): unclear (normalization of brain activity)
57 Totomanova et al. 2025systematic reviewmicrodosing with LSD or psilocybin; low doses (not further specified); regular use; experimental studies partly single dose; vs. placebo-controlled trials vs. observational studiescognition: improved; cognitive disruption: worsened
60 Velit-Salazar et al. 2024systematic reviewPsilocybin (alongside MDMA, cannabis, LSD, DMT/ayahuasca, mescaline); vs. Comparison between psychedelics and control conditions or baselineNeurocognition (cold cognition) under psilocybin: unclear
66 Ramos et al. 2024systematic reviewPsilocybin; vs. Control groups in randomized and non-randomized controlled trialsAttentional and inhibitory processes: worsened; Creativity: improved; Social cognition: improved
72 Qasim et al. 2023systematic reviewPsilocybin with assisted psychotherapy; vs. Randomized, double-blind or open-label; controls not reportedGlobal connectivity and brain activation: unclear
78 Gill et al. 2022systematic reviewPsilocybin; vs. no comparison; review of neuroimaging observationsfunctional connectivity and activation of prefrontal limbic structures: unclear (Changes in functional connectivity and activation of prefrontal limbic structures, specifically the ventral medial prefrontal cortex and amygdala, was seen in healthy populations)

Further studies in this area: 79 85 99 101 115 123 143 145 161 167 183 189 191 194 196 198 232 269 282

Psilocybin (Magic Mushrooms), Headache and Migraine: Human Studies

There are only a few very small studies on cluster headache and migraine. In cluster headache, the number of attacks in a randomized study did not differ significantly from placebo 154; in the blinded extension phase, it decreased compared with baseline 162. In migraine, a non-randomized controlled crossover study found a reduction in weekly migraine days, while a randomized controlled study with active placebo showed no difference in migraine days and migraine frequency 202152. In contrast, there are indications of headache as an adverse event under therapeutic psilocybin doses: one meta-analysis reported headache with synthetic psilocybin as a capsule 11, another an increased risk of headache under psilocybin-assisted psychotherapy 18, and a third an increased incidence of headache with synthetic psilocybin as a capsule 34. Overall, the data are limited: the controlled studies include only very few participants, and the observation periods are short. Reviews on psychedelics in general, including LSD and DMT, see preliminary indications of benefit in migraine and cluster headache; the contribution of psilocybin cannot be separated within them 273287301. For microdosing with very small doses, the effect on pain is unclear, since the available surveys are predominantly based on self-reports 3.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
3 Page et al. 2026systematic review · 3,262 participantspsilocybin magic mushrooms and truffles; extremely heterogeneous dosing protocols, no uniform dose; vs. no uniform comparator; mostly self-reported, qualitative studiespain: unclear
11 Yerubandi et al. 2024meta-analysis · 528 participantsPsilocybin at therapeutic doses (high or moderate); therapeutic single dose (high or moderate); acute effects, resolved within 48 hours; vs. placebo, low-dose psilocybin, or other comparatorHeadache (RR, 1.99; 95% CI 1.06-3.74)
14 Perez et al. 2023systematic review · 489 participantsPsilocybin, fixed dose, double-blind placebo-controlled; ED95 8.92 / 24.68 / 36.08 mg/70 kg per group; vs. Placebodose-response association for headache/migraine (significant dose-response associations)
18 Menon et al. 2025meta-analysis · 427 participantsPsilocybin-assisted therapy (PAT); Follow-up up to day 42 (6 weeks); vs. Comparator treatmentsRisk of headache (RR = 1.78; 95% CI, 1.10-2.86; I2 = 52%; 4 RCTs; n = 373)
34 Kishi et al. 2026meta-analysisPsilocybin, partly with manualized psilocybin-assisted psychotherapy; Standard dose 25 mg/session or 20-30 mg/70 kg; low dose 10 mg or 15.05 mg/70 kg; Follow-up 2-3 weeks and 6-12 weeks post-treatment; vs. Placebo, waiting-list control, niacin, or psilocybin 1 mgIncidence of headache (RR: 2.06; 95% CI: 1.11-3.81, p = 0.02)
62 Robinson et al. 2024systematic reviewPsilocybin and other psychedelics (LSD, 2C-B, DMT, mescaline); vs. Randomized double-blind placebo-controlled trial plus open-label, case reports, cohort, online surveysPain relief in chronic pain conditions: improved
65 Madden et al. 2024systematic reviewPsilocybinFrequency of headaches (6%)
152 Schindler et al. 2026randomised controlled · 18 participantsPsilocybin 10 mg versus diphenhydramine 25 mg as active placebo; Zero, one, or two doses of psilocybin 10 mg; otherwise diphenhydramine 25 mg; Two drug sessions 7 days apart; 8 weeks of follow-up; vs. Diphenhydramine placebo (diph-diph) versus one (diph-psi) or two (psi-psi) psilocybin dosesChange in migraine days per week at 2 weeks: no difference (diph-diph: -0.7 (95% confidence interval, -1.5 to 0.2); diph-psi: -2.0 (-3.0 to -1.0); psi-psi: -1.7 (-4.1 to 0.7); Χ2 (2) = 4.56, p = 0.102); 50% response rate over 2 weeks: unclear (diph-diph: 17%; diph-psi: 80%; psi-psi: 80%; p = 0.087); Reduction in migraine frequency over 8 weeks: no difference (approximating 50%)

Further studies in this area: 154 162 202 242 273 287 301 306

Psilocybin (Magic Mushrooms): Further Outcomes in Studies

For the other outcome measures, the picture is mixed. Meta-analyses and reviews describe improvements in quality of life, pain control and spiritual well-being in cancer patients 2429, in demoralization 2247 and in well-being 3271. Suicidal thoughts decreased more in a meta-analysis than under control 10; one review found this in one of five randomized studies 16. One controlled study reported increased suicidal thoughts on dosing days 93. Adverse events such as nausea, dizziness and increase in blood pressure occurred in several controlled studies and meta-analyses 111819. Serious adverse events and study dropouts, by contrast, were not more frequent in meta-analyses than under placebo 6481. Many studies are small, short and heterogeneous, and the results depend on dose, number of sessions and support.

StudyDesign · participantsPreparation · dose · duration · comparisonResult
1 Guo et al. 2024meta-analysis · 12,105 participantsPsilocybin versus seven other augmentation therapies; vs. placebo and other augmentation strategiestolerability
2 Eskinazi et al. 2026systematic review · 7,478 participantsSerotonergic psychedelics (psilocybin, LSD, mescaline, DMT/ayahuasca) or MDMA; vs. Controlled trials vs. naturalistic studies; registry cohortsRate of psychedelic-associated dysphoria/euphoria, hypomania or mania: unclear (5.8% in controlled trials of psilocybin-assisted psychotherapy for major depressive disorders to 30% in naturalistic studies of individuals with bipolar disorder); Prevalence of subsequent transition to bipolar disorder: unclear (4% (95% CI 2-8%; N = 7478; I² = 32.1%))
3 Page et al. 2026systematic review · 3,262 participantspsilocybin magic mushrooms and truffles; extremely heterogeneous dosing protocols, no uniform dose; vs. no uniform comparator; mostly self-reported, qualitative studieswell-being, mental health, cognition, creativity, etc.: unclear (certainty of the evidence is low)
4 Piper et al. 2025systematic review · 2,035 participantsPsilocybin-assisted treatment (comparators: LSD, mescaline, ayahuasca, ketamine, ibogaine, MDMA); vs. Placebo-controlled RCTs and open-label studiesSerious adverse events (no serious adverse events reported in any study)
5 Haft et al. 2025systematic review · 1,034 participantsPsilocybin- and MDMA-assisted psychotherapy; vs. US population and non-psychedelic clinical trialsReporting of gender: no difference (100%); Reporting of race or ethnicity: no difference (76%); Reporting of socioeconomic status: no difference (57%)
6 Thomson et al. 2025systematic review · 949 participantsPsilocybin (8 studies), plus 5-MeO-DMT, ayahuasca, LSD; Outcome measured at least 7 days post-consumption; vs. controlled or naturalistic designEnduring enhancement of PERMA's five well-being elements: improved
10 Wong et al. 2025meta-analysis · 593 participantsPsilocybin therapy (PT); vs. Control groupSuicidal ideation (SMD): improved (SMD = -0.24, 95% CI -0.42 to -0.06, p = 0.008); Suicide attempts: unclear (No study reported suicide attempts or suicide deaths)
11 Yerubandi et al. 2024meta-analysis · 528 participantsPsilocybin at therapeutic doses (high or moderate); therapeutic single dose (high or moderate); acute effects, resolved within 48 hours; vs. placebo, low-dose psilocybin, or other comparatorNausea: worsened (RR, 8.85; 95% CI, 5.68-13.79); Dizziness: worsened (RR, 5.81; 95% CI, 1.02-33.03); Elevated blood pressure: worsened (RR, 2.29; 95% CI, 1.15- 4.53)

Further studies in this area: 12 14 15 16 18 19 22 24 26 29 30 31 32 34 35 38 40 42 43 45 46 47 51 56 57 58 59 60 63 64 65 67 68 71 74 75 77 79 80 81 84 85 86 87 89 90 93 95 96 97 99 100 101 103 106 107 110 111 112 115 119 121 123 125 126 127 129 133 134 135 137 138 139 140 141 142 143 144 146 147 149 150 153 155 156 157 158 159 163 164 165 166 167 168 169 171 172 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 192 193 195 197 199 200 201 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 227 228 230 233 234 236 237 239 240 243 244 245 246 247 248 253 254 255 260 264 265 266 267 268 270 273 277 280 281 282 287 291 292 293 295 298 299 301 302 308 309 313 316

4. How Is Psilocybin (Magic Mushrooms) Dosed? Preparation, Dose and Duration in Studies

The controlled studies predominantly used synthetic psilocybin as a capsule, usually with psychological support, as well as psilocybin-assisted psychotherapy. In addiction, dried mushrooms and truffles were also used. Microdosing with very small doses was investigated in individual studies on anxiety, memory and pain; the data situation on this is inconsistent. Dose, number of sessions and therapeutic support differ between the studies and shape the results.

Preparation or formDoseDurationStudy
COMP360 psilocybin, synthetic, with psychological support25 mg, 10 mg or 1 mgup to Week 3 after Baseline90
COMP360, synthetic psilocybin, with psychological supportSingle dose of 25 mg, 10 mg, or 1 mg (control)Single dose, assessment at Week 391
proprietary synthetic psilocybin formulation with psychological supportSingle dose 25 mg, 10 mg, or 1 mg (control)3 weeks primary, 12 weeks follow-up92
Oral synthetic psilocybin with adjunct psychotherapeutic sessions25 mg or 5 mg psilocybin; placebo nicotinamide 100 mg; 2 doses 6 weeks apartPrimary endpoint at week 6, before the second dose93
Psilocybin with adjunct psychotherapy (7 sessions)5 mg or 25 mg psilocybin, two administrations 6 weeks apartControlled phase 12 weeks, follow-up up to 12 months94
LSD and/or psilocybin, partly with MDMA, D-amphetamine, escitalopram—Follow-up mean 31.2 months95
25 mg synthetic psilocybin capsule with psychological support25 mg single doseSingle dose, follow-up to day 4397
Psilocybin vs diphenhydramine (active placebo), both with psychotherapy25 mg/70 kg (session 1); 25-40 mg/70 kg (session 2)2 sessions at weeks 4 and 8; 32-week double-blind period98
Psilocybin 10 mg or 25 mg vs. inert placebosingle dose 10 mg or 25 mgfollow-up day 8 and day 8599
Psilocybin (synthetic, capsule)single dose placebo, 10 mg or 25 mg psilocybin—100
Single oral psilocybin dose, administered simultaneously to up to six participants, with one-to-one psychological support10 mg or 25 mg psilocybinMedian TEAE duration 1.0 day; short- and longer-term follow-up101
Psilocybin plus manualized psychotherapy—2 medication sessions, 12 psychotherapy sessions102
psilocybin dihydrate, single oral doses15 mg, 20 mg, 25 mg, 30 mg113 single-dose administrations; follow-up at study end103
Psilocybin plus 12 weekly psychotherapy sessionstwo psilocybin medication sessions36 weeks follow-up104
One high dose of psilocybin (30 mg/70 kg) plus manualized CBT30 mg/70 kg, single dose13-week CBT program, 6-month follow-up105

5. Is Psilocybin (Magic Mushrooms) Safe? Side Effects in Studies

The studies report predominantly mild and temporary side effects such as nausea, headache, dizziness and temporary increase in blood pressure 1118192734. Serious adverse events and study dropouts were not more frequent than under placebo in meta-analyses 6481; several reviews found no serious adverse events 471. Individual studies reported temporary anxiety, suicidal thoughts on dosing days or flashbacks 1193103. Tolerability depended on dose and support.

StudyReported side effects
1 Guo et al. 2024Psilocybin exhibited lower tolerability
2 Eskinazi et al. 2026Dysphoria/euphoria, hypomanic or manic symptoms, transition to bipolar disorder
3 Page et al. 2026mostly mild; majority of studies reported none
4 Piper et al. 2025No serious adverse events reported in any study
6 Thomson et al. 2025No serious adverse effects in six studies; adverse effects often not discussed
9 Borgogna et al. 2025Harm reporting low/very low in 5 studies, high in 2
11 Yerubandi et al. 2024headache, nausea, anxiety, dizziness, elevated blood pressure significant; paranoia and transient thought disorder not significant
12 Fang et al. 2024generally transient and reversible, serious events possible
14 Perez et al. 2023Physical discomfort, blood pressure increase, nausea/vomiting, headache/migraine, prolonged psychosis
15 van et al. 2022few (serious) adverse events
16 Li et al. 2024Most common adverse drug reaction in both groups: headache
18 Menon et al. 2025Increased risk of any adverse event, headache and dizziness

6. What Remains Open: Limits of the Evidence

  • Many controlled studies are small, short and heterogeneous, which limits the transferability of the results.
  • The long-term effect beyond the investigated periods is open.
  • The contribution of therapeutic support to the result cannot be reliably separated.
  • In dementia and Alzheimer's, studies in affected individuals are lacking; the findings on the brain come from healthy adults and people with depression.
  • For microdosing with very small doses, the data situation is based predominantly on self-reports.

7. Bottom Line: What Is Established About Psilocybin (Magic Mushrooms)

Psilocybin, the active substance in magic mushrooms, is converted in the body to psilocin and alters perception, mood and thinking. Controlled studies show improvements in depression and obsessive-compulsive disorder; for alcohol dependence and smoking cessation, there are initial small randomized studies with positive results. For anxiety in the context of serious illness, a meta-analysis found an advantage over placebo, while other anxiety measures showed no difference. For dementia and Alzheimer's, studies in affected individuals are lacking. The results apply to synthetic psilocybin as a capsule, psilocybin-assisted psychotherapy as well as dried mushrooms and truffles, usually with psychological support. Many studies are small, short and heterogeneous; the long-term effect and the contribution of support remain open.

Frequently Asked Questions

How well has Psilocybin (magic mushrooms) been studied in humans?

We evaluated 323 human studies on Psilocybin (magic mushrooms), including 90 randomised controlled trials and 88 meta-analyses or systematic reviews; the controlled studies include 5,670 participants in total. As of 3 October 2026.

Does Psilocybin (magic mushrooms) help with depression? What the studies show

We evaluated 40 meta-analyses or systematic reviews, 36 controlled studies and 78 further studies; the controlled studies include 1,707 participants in total. Result of the controlled studies: mostly improved. Strength of evidence under our published rules: high. Sources: 1789

Does Psilocybin (magic mushrooms) help with anxiety and distress in serious illness? What the studies show

We evaluated 16 meta-analyses or systematic reviews, 11 controlled studies and 41 further studies; the controlled studies include 384 participants in total. Result of the controlled studies: mixed. Strength of evidence under our published rules: high. Sources: 11162224

Does Psilocybin (magic mushrooms) help with addiction: alcohol and smoking? What the studies show

We evaluated 8 meta-analyses or systematic reviews, 10 controlled studies and 30 further studies; the controlled studies include 475 participants in total. Result of the controlled studies: mostly improved. Strength of evidence under our published rules: high. Sources: 342223

Does Psilocybin (magic mushrooms) help with obsessive-compulsive and eating disorders? What the studies show

We evaluated 5 meta-analyses or systematic reviews, 5 controlled studies and 9 further studies; the controlled studies include 83 participants in total. Result of the controlled studies: mostly improved. Strength of evidence under our published rules: high. Sources: 22265265

Does Psilocybin (magic mushrooms) help with memory, dementia and Alzheimer's disease? What the studies show

We evaluated 7 meta-analyses or systematic reviews, 12 controlled studies and 8 further studies; the controlled studies include 417 participants in total. Result of the controlled studies: mostly no difference. Strength of evidence under our published rules: moderate. Sources: 31374857

Does Psilocybin (magic mushrooms) help with headache and migraine? What the studies show

We evaluated one meta-analysis or systematic review, 3 controlled studies and 12 further studies; the controlled studies include 44 participants in total. Result of the controlled studies: mostly no difference. Strength of evidence under our published rules: low. Sources: 3111418

What is psilocybin and how does it work?

Psilocybin is the active substance in so-called magic mushrooms, especially fungi of the genus Psilocybe. In the body, it is converted to psilocin, which binds to serotonin receptors in the brain, especially at the 5-HT2A receptor. As a result, perception, mood and thinking change for a few hours.

Which forms of psilocybin were investigated in human studies?

The controlled studies predominantly used synthetic psilocybin as a capsule, usually with psychological support, as well as psilocybin-assisted psychotherapy. In addiction, dried mushrooms and truffles were also used. Microdosing with very small doses was investigated in individual studies; the data situation on this is inconsistent.

Do human studies show an effect in depression?

In depression, psilocybin showed an improvement in symptoms on the MADRS scale in several controlled studies 9297108117. On the HAM-D scale, the values in a randomized study were significantly lower than those of the waiting group 136; in follow-up observations, the improvement lasted up to twelve months 94135.

How safe is psilocybin in the investigated studies?

The studies report predominantly mild and temporary side effects such as nausea, headache, dizziness and temporary increase in blood pressure 1118192734. Serious adverse events and study dropouts were not more frequent than under placebo in meta-analyses 6481; several reviews found no serious adverse events 471. Individual studies reported temporary anxiety, suicidal thoughts on dosing days or flashbacks 1193103.

What is known about the effect in dementia and Alzheimer's?

Studies in people with dementia or Alzheimer's are lacking; in healthy individuals and in depression, psilocybin altered brain networks and EEG signals 143145183198. The results predominantly concern healthy adults and people with depression, not individuals with dementia or Alzheimer's.

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    Impact of Psilocybin on Peripheral Cytokine Production
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    Mystical but Not Challenging Experiences Predict Symptom Improvement After Psilocybin for Treatment-Resistant OCD
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    [Psychedelic psychiatry]
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    Potential Therapeutic Effects of Psilocybin
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Every statement on this page carries its evidence tier — proven, plausible or hypothesis — and leads to the original work. The decision in the individual case rests with the practitioner; we provide the connections.

International Health Research · https://ih-research.com/en/knowledge/psilocybin/ · Last updated: 2026-10-15